POS0743 CLINICAL CHARACTERISTICS AND BURDEN AMONG PATIENTS WITH SLE AND MUSCULOSKELETAL ORGAN INVOLVEMENT: RESULTS FROM A REAL-WORLD STUDY IN THE US
Authors: A. Vadhariya, J. Birt, J. Wu, K. Griffing, F. Bailey, J. Hetherington, E. Rottier, S. Barlow, K. Costenbader
Journal: Annals of the Rheumatic Diseases (2022)

Background Limited information exists concerning the clinical burden and unmet need of musculoskeletal (MSK) organ involvement among patients with SLE in clinical practice. Objectives To examine demographics, clinical status, treatment patterns, and patient-reported outcomes (PROs) among patients with SLE in clinical practices and assess the impact of MSK organ involvement. Methods Data were drawn from the Adelphi Real World Lupus IV (2021) Disease Specific Programme™, a point-in-time survey of 79 US physicians and their patients with SLE. Physicians completed questionnaires regarding patient demographics, clinical status, and treatment. The same patients were invited to complete questionnaires containing the EuroQoL 5-Dimensions (EQ-5D), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-Fatigue) and Work Productivity &amp; Activity Impairment questionnaire (WPAI) PRO tools. Physicians stated their patients’ organ involvement at the time of data collection (current), in the categories of musculoskeletal, mucocutaneous, renal, cardiorespiratory, constitutional, haematologic, ophthalmologic, gastrointestinal, respiratory, or other. Two mutually exclusive patient groups were analysed: A.MSK – Current physician assessed musculoskeletal organ involvement (+/- other organ/tissue involvement). B.Non-MSK – No current musculoskeletal organ involvement as assessed by the physician Bivariate analysis was conducted for numeric variables using t-tests; binary categorical variables using a Fisher’s exact test; ordinal categorical variables using a Mann-Whitney test; and other categorical variables were compared using a chi-squared test. Results A total of 595 patients were included in this analysis: 64.7% MSK and 35.3% non-MSK. Mean[SD] patient age was 45.2[14.3] years, 83.2% were female, 53.3% were White/Caucasian, 27.9% were African American, and mean[SD] time diagnosed with any SLE was 5.3[6.2] years. Point-in-time assessment of clinical status, treatment patterns and patient-reported outcomes, revealed that those with MSK organ involvement assessed by their rheumatologist had higher overall SLE disease severity, more flares in the last 12 months, and slightly worse quality of life scores and work impairment. Table 1. Point-in-time clinical status, treatment patterns and PROs among patients with SLE MSK organ involvement Total MSK Non-MSK p value (n=595) (n=385) (n=210) Physician-Reported Patient Clinical Status &amp; Treatment History Current SLE severity, n(%) Mild 405 (68.1) 243 (63.1) 162 (77.1) &lt;0.001 Moderate 169 (28.4) 128 (33.3) 41 (19.2) Severe 21 (3.5) 14 (3.6) 7 (3.3) Current joint symptoms, n(%) Joint tenderness 251 (42.2) 210 (54.6) 41 (19.5) &lt;0.001 Joint stiffness 255 (42.9) 212 (55.1) 43 (20.5) &lt;0.001 Joint swelling 135 (22.7) 111 (28.8) 24 (11.4) &lt;0.001 Mean [SD] Flares in the last 12 months 1.6 [1.7] 1.7 [1.8] 1.2 [1.3] 0.015 Currently prescribed, n(%) Belimumab 113 (19.0) 79 (20.5) 34 (16.2) 0.198 Immunosuppressant 164 (27.6) 105 (27.3) 59 (28.1) 0.830 Corticosteroids 333 (56.0) 228 (59.2) 105 (50.0) 0.030 Antimalarials 429 (72.1) 268 (69.6) 161 (76.7)) 0.067 Mean [SD] years on current treatment 2.9 [3.6] 2.5 [3.0] 3.6 [4.4] &lt;0.001 Patient-Reported Outcomes Mean [SD] EQ5D-5L Utility score (0= death to 1= full health) 0.79 [0.20] 0.76 [0.22] 0.85 [0.16] 0.002 Mean [SD] FACIT-Fatigue score (0 worst fatigue to-52= no fatigue) 32.4 [12.0] 31.0 [11.5] 35.4 [12.6] 0.005 Mean [SD] WPAI, overall work impairment score(0= no impact to 100= completely impacted) 29.0 [21.0] 30.5 [18.6] 25.9 [25.2] 0.223 Conclusion In this large sample of patients with SLE followed in clinical practices in the U.S., compared to those with little or no rheumatologist assessed MSK involvement, those with MSK involvement, had lower quality of life, with higher impact on their work productivity. These results highlight the heterogeneity of SLE and the impact of major MSK manifestations on quality of life in SLE. References N/A Disclosure of Interests Aisha Vadhariya Employee of: Eli Lilly and Company, Julie Birt Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jianmin Wu Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Kirstin Griffing Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Fiona Bailey: None declared, James Hetherington: None declared, Elke Rottier: None declared, Sophie Barlow: None declared, Karen Costenbader Consultant of: Lilly, Astra Zeneca, Janssen, Amgen, Glaxo Smith Kline, Grant/research support from: Exagen, Gilead, Merck